Our social value 2017-2018 by Medway Community Healthcare

Our social value 2017 - 2018

Medway Community Healthcare CIC providing services on behalf of the NHS Registered office: MCH House, Bailey Drive, Gillingham, Kent ME8 0PZ Tel: 01634 337593 Registered in England and Wales, Company number: 07275637

Welcome Welcome to our social value report for 2017/18 – our chance to tell you about the positive impact we have had on the people we care for, our staff and the communities we serve. Medway Community Healthcare (MCH) is an independent Community Interest Company providing high quality health and social care services in Medway and across Kent. The majority of the services we deliver are for the NHS, and we’re incredibly proud to be part of the NHS family, as it celebrates its 70th year. We’ve thoroughly enjoyed the celebrations – reliving our shared healthcare history across Medway and the wider UK. While our NHS work is hugely important, we’re also proud to be a social enterprise. Our status sets us apart, because social value is part of our DNA – it’s embedded in our business culture, decision making and strategies. We support and encourage our teams to innovate and develop and they continually do us proud by looking ahead and thinking about the future of health and social care, while living our values to ensure that we keep the people we care for and our communities at the heart of everything we do. As we move into our eighth year as a social enterprise, our environment in which we work is increasingly challenging. Like our NHS colleagues and fellow social enterprises, we face the increasing cost of living and working, and an increasing demand for our services. I find myself astounded by my colleagues’ creativity, motivation and dedication to continuing to deliver great care to our service users within this environment; and so we were delighted to recognise their hard work by awarding the NHS pay award. As well as listening to our staff and acting on their insight and ideas, we will continue to seek opportunities to work in partnership with other care providers to ensure continuity of care for our patients, as well as partnering with other organisations who can help us deliver wider positive outcomes for local people. We will continue to deliver additional social value both through the way we do business and through projects specifically designed to make a difference; ensuring that MCH continues to be an organisation to be proud of. Since our creation in April 2011 we have successfully delivered surpluses that we’ve used to further improve our health and care services, and implemented new initiatives to deliver added social value based on the needs of our communities. The CQC has consistently rated our services as Good, in recognition of the high quality care we provide for local people. I would like to thank all of my MCH colleagues for continuing to go the extra mile and for their compassion and commitment to our patients, service users and local people.

Martin Riley Managing Director Medway Community Healthcare CIC providing services on behalf of the NHS Registered office: MCH House, Bailey Drive, Gillingham, Kent ME8 0PZ Tel: 01634 337593 Registered in England and Wales, Company number: 07275637

Our year We continue to work hard to make a difference, building on our achievements and using our understanding of the needs of our communities to develop new ways to deliver high quality care and add social value. In 2017-18, we: 

Provided high quality care through 921,495 consultations for the people we care for;

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Collected feedback from our patients and service users to check if people are happy with their care and 95% of people who responded told us that the care they received was good or very good;

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Received 1,612 unsolicited compliments from the people we care for, receiving four times as many compliments as complaints. Our commitment to listening to our patients and responding to feedback helps us learn and continue to improve our services for the people we care for;

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Saw our Sunlight Centre GP Surgery inspected by the CQC; who rated it Good in all categories;

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Continued to increase our spending with local businesses by 15%, buying 37% of our goods and services locally and spending £3.8m with local businesses;

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Recruited another 11 local young people onto our apprenticeship programme, supporting them to take the first step in their careers;

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Recruited 2 of our apprentices into full time permanent positions with our teams once they gained their qualifications;

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Saw our first two MCH Academy sponsorship students successfully complete their business degree courses and graduate from Canterbury Christ Church University; and saw our third sponsorship student successfully complete the second year of his degree;

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Provided jobs for 234 new members of staff;

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Offered multiple work experience placements across our services to enable local people to improve their skills and gain experience in health and care services;

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Supported fundraising activities by our staff who successfully raised over £12,100 for many local and national charities in the past year

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Recruited paramedic responders to work with our community nursing teams seven days a week to support the nursing staff when patients become very unwell at home; a junior nurse can phone the paramedic who can complete a full assessment of the patient in their own home, helping prevent patients from needing to be admitted to hospital;

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Coordinated a Christmas collection for Medway Foodbank, collecting 245.8kg of food kindly donated by our staff and the people we care for; 40% more donations than the previous year;

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Ran a Fun in the Sun day at Shorne Country Park to support parents and carers of children with therapy needs to improve their confidence in attending public places; creating a friendly, welcoming environment and showcasing activities to do together as a family that can be easily recreated at home;

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Introduced a new orthotics clinic at our Walter Brice Centre in Hoo, making it easier for patients on the peninsula to access the service and improving patient experience;

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Supported our 3,000th patient to be discharged from hospital under the care of our award winning Home First service, enabling them to begin their rehabilitation in the community and in their own homes;

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Our emergency dental service, dentaline, introduced advice calls offering information and advice and improving the support we provide to local people;

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Completed the refurbishment of ‘ourZone’, our social activity centre; improving the environment for our members and enhancing the service we provide. This included introducing clinics for our community health services within the building to make it easier for members and local people to access care provided by our teams, including diabetes, podiatry and nutrition and dietetics services;

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Our diabetes education courses have been ranked amongst the best in the country, with audit results showing completion rates for the courses at nearly 90%;

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Launched the new Wellbeing and Therapy Centre at our Wisdom Hospice; offering a variety of therapies and opening the service to a wider group of patients, improving the service we offer for palliative patients in Medway;

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Our nutrition and dietetics team worked in partnership with Medway Clinical Commissioning Group to refresh the guidelines on oral nutritional supplements, using their expertise to ensure the guidelines are up to date and supplements are prescribed appropriately;

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Held our first annual Research Forum to encourage and support MCH staff to get involved in research; with speakers from our partner research organisations as well as MCH staff discussing their experiences of research studies, how we are working with other organisations and members of the public and the benefits this brings for our patients.

Our social enterprise MCH is a £64 million Community Interest Company that is co-owned by our staff. As a social enterprise, we are a for better profit organisation and we reinvest any surplus into improving our health and care services. Our 1,322 staff provide over 50 high quality NHS community services and personalised social care in and around Medway – from community nursing and dementia care to specialist rehabilitation services and children’s therapy teams, caring for a population of around 280,000 people. Being a social enterprise makes us different:  Our staff have a say in developing our business plans for the future and reinvesting any surplus;  Our patients, service users, our staff and members of the local community have a say in designing how we provide our services;  We are flexible and able to adapt to the changing needs of the people we care for;  We are committed to delivering added social value and wider benefits for our communities alongside our high quality health and social care services. In 2017-18 we provided care in local community settings such as healthy living centres and Children’s Centres, as well as our inpatient services at Darland House Nursing Home, the Wisdom Hospice, our rehabilitation wards at Amherst Court, and in people’s homes. Social value is at the centre of our business culture and we support our staff to identify opportunities for improvement and develop plans for change, ensuring the people we care for are at the heart of everything we do.

Our vision Our vision for our organisation now and for the future is to be: A successful, vibrant, community interest company that benefits the communities we serve. By 2020 our ambition is to be a model for sustainable delivery of NHS services which is recognised as a beacon of excellence.

Our values Developed with the help of our staff and stakeholders, our values underpin everything we do and support us to work together with a shared understanding to help us achieve our vision: Medway Community Healthcare CIC providing services on behalf of the NHS Registered office: MCH House, Bailey Drive, Gillingham, Kent ME8 0PZ Tel: 01634 337593 Registered in England and Wales, Company number: 07275637

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We are caring and compassionate We deliver quality and value We work in partnership

Our values are embedded into our recruitment and the ongoing career development of our staff and help shape our quality priorities each year.

Award winning care We are continually working to improve the quality of our services for the people we care for and are proud to have won a number of awards in recognition of our high quality care and the commitment shown by our staff, including: 

Our speech and language therapy team, together with two of our service users, were presented with a Royal College of Speech and Language Therapists ‘Giving Voice’ award in September 2017 by Her Royal Highness The Countess of Wessex, in recognition of their work demonstrating how speech and language therapy transforms lives. The team worked together with a number of service users to raise the profile of their team and their profession by holding a showcase day filled with inspirational stories told by patients and debuting a film about speech and language therapy;

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Our diabetes team was recognised at the X-pert Awards 2017, taking first place for ‘the greatest number of participants to attend the programme’; and second place for ‘the largest impact on body weight and waist circumference’;

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MCH signed up to the National Workplace Wellbeing Charter, an opportunity for employers to demonstrate their commitment to staff health and wellbeing. It consists of eight standards, which are each given a rating of commitment, achievement or excellence. MCH was awarded: Leadership: Commitment Absence Management: Excellence Health and safety: Achievement Mental Health: Achievement Smoking: Commitment Physical Activity: Achievement Healthy eating: Achievement Alcohol and substance misuse: Achievement

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MCH is now registered with the DWP as a ‘Disability Confident Employer’

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Angel Cornell, advanced nurse practitioner at our Sunlight Centre GP Surgery, was named runner up in the Paula Carr Diabetes Category at the Kent and Medway General Practice Nurse Awards;

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Kate Browning, volunteer at Wisdom Hospice, won the Order of Mercy award for her 23 years’ service at Wisdom Hospice in a variety of roles starting as a driver and now providing spiritual care.

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HEKSS Apprentices and Support Worker Awards; a number of MCH staff were successful at the Health Education, Kent Surrey and Sussex Apprentices and Support Worker Awards; Luigi Fiore won the ‘working above and beyond the call of duty’ category, and Claire Mills was runner-up. Chelsea Spain was runner-up in the ‘compassion and care’ category; and Wayne Mitchell was runner-up in the ‘working to improve the patient experience’ category.

Our impact on… the people we care for Our staff regularly identify opportunities to improve our services and introduce new activities that complement and enhance the care we provide. We use these opportunities to deliver additional social value and make a positive impact on the health and wellbeing of the people we care for. Some of the opportunities we’ve explored in 2017-18 are: 

Our stroke service worked in partnership with Medway Council’s Shared Lives service to design a bespoke rehabilitation programme for a 38 year old stroke patient with a young teenage daughter. Designed around the patient’s specific needs, the innovative programme has so far enabled her to:  Return to living independently in her own flat;  become independently responsible for her medication;  re-establish her relationship with her daughter; and  begin doing voluntary work;

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Our community dental service organised the first annual Oral Health Champions training day for representatives from our services and Medway Maritime Hospital to improve their skills in oral health and to learn about its importance in maintaining and improving general health. The event was led by a dentist and established a network of Oral Health Champions who will share their learning with their teams and promote the importance of oral health within their services;

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Redesigning the service we provide at our Walter Brice Centre in Hoo, emphasising outcomes for patients and quality of care and realigning resources to focus on clinical outcomes. This enabled us to employ an additional rehabilitation assistant to better support our patients;

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Our nutrition and dietetics team organised a nutrition study day for representatives from our services and staff from Medway Maritime Hospital. The event improved knowledge and understanding of how to support good nutrition for patients, as well as providing specialist advice on complex issues such as caring for patients with enteral feeding tubes;

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Our health visiting team worked with our Walter Brice Centre in Hoo to pilot a Saturday clinic for three months. After a successful pilot the clinic is now permanent, improving access to the service for patients on the peninsula and helping us to better meet the needs of our patients;

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We worked with Medway Maritime Hospital to offer pregnant women the blood test for gestational diabetes at eight community locations across Medway with a range of

appointment times. This has made it easier for patients by offering appointments at their local clinic instead of needing to travel to the hospital, improving access and choice for local people; 

Our speech and language therapy service provided specialist training to local care homes and staff on our rehabilitation wards on how to look after people with swallowing difficulties; improving their attendees’ knowledge and skills and helping them provide better care for their patients;

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Our dementia crisis support service provided training for our long term conditions teams on prescribing for people with dementia; improving understanding of how the condition affects other aspects of health and raising awareness of the support the team provides for people with dementia and their families;

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Our community nursing service has successfully expanded the provision of IV medication to patients in the community. The team now provides IV therapy 24/7 outside of hospital, making it easier for patients to access care and improving patient experience. The nurses have also developed a training package to teach patients to administer their IV medication themselves (if they choose to), helping people to self-manage their care and play an active role in their recovery;

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We reviewed the locations and capacity of clinics for our musculoskeletal physiotherapy service and our clinical assessment service to increase availability of appointments. We used patient feedback to ensure that clinics are meeting patients’ needs, and as a result, we increased provision of the services in Strood, Rainham and Gillingham, and introduced new clinics at our Walter Brice Centre in Hoo;

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Our musculoskeletal physiotherapy service is one of a small number of teams nationally to offer pelvic health treatments for both men and women, increasing the range of treatment options available for patients. Our expertise has been recognised nationally and one of our lead physiotherapists presented on the role of physiotherapy in managing pelvic health issues at a national conference for doctors, increasing understanding of the benefits of pelvic health physiotherapy for patients;

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Our nutrition and dietetics team developed and introduced an enteral feeding ‘passport’ for patients with enteral feeding tubes to help improve education and prevent complications and readmission to hospital, improving quality of life for patients;

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We established ‘Holding Hands’, a social prescribing programme for children with therapy needs and their families to support them to engage with activities in the community including sports and hobbies. Our therapy staff provide advice for club leaders on supporting children with additional needs, making it easier for children to get involved in activities which have a positive impact on children’s and families’ wellbeing and resilience;

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Our speech and language therapy team worked with Amherst Court care home to enable MCH patients to access the art group, enabling them to benefit from art therapy to practice vocalisation, stimulate processing and encourage conversation;

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Our diabetes team worked with our community nursing service to review patients with diabetes. The specialist team help to ensure that any changes in their conditions are acted upon and that patients continue to receive appropriate support for their needs, including referring patients back to their GP or into the diabetes service for specialist care if needed. Representatives from our diabetes team also attend community nursing meetings to promote effective communication between the services, supporting the provision of high quality care for our patients;

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Our podiatry service runs regular training sessions for ‘touch the toes testing’ for staff at Medway Maritime Hospital to support them to care for their patients’ feet and understand the specific foot care needs of people with diabetes. This helps to prevent pressure ulcers and reduces the number of days patients need to stay in hospital;

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Our specialist staff ran a series of long term conditions education sessions to support colleagues to update their knowledge about cardiology, respiratory and diabetes; enabling them to better support patients to manage their conditions and continue to live independently and well;

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Our community nursing team have increased their partnership working with local GP practices to support patients with complex needs and palliative patients. They work together to share information and coordinate support to deliver high quality care and improve the experience of care for patients in need and at the end of life;

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As a Dementia Friendly organisation we encourage each service to nominate a dementia champion to support their colleagues to better understand dementia and provide advice within their service, helping to improve care for people with dementia;

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Our on-call GP service, MedOCC, further developed our partnership with South East Coast Ambulance Service to enable paramedics to phone the service to request advice about their patients and agree a joint management plan. This successfully reduced the number of patients needing to be transferred to hospital by ambulance and helped to reduce pressure on local hospitals;

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We ran information sessions for staff at Medway Maritime Hospital to raise awareness of our award winning ‘Home First’ service to improve understanding of how the service benefits patients, helping to ensure more patients are supported to leave hospital quickly and safely with plans for on-going care and rehabilitation in the community;

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Our GP surgeries have been working closely with local universities to enable students to book emergency GP appointments through the student wellbeing team at the university, making it easier for students to access healthcare and improving patient experience;

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Our tissue viability team have built on the success of their pilot, degree level, leg ulcer management course for community nurses by running the course for a second year and offering places to nurses from other organisations as well as MCH staff. The course is designed and delivered by our specialist nurses, accredited by Canterbury Christ Church University and contributes towards nurses’ degrees; supporting them to develop their knowledge and skills and improving care for patients;

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Our safeguarding team worked in partnership with Medway Council to run self-neglect training workshops for MCH and Medway Council health and social care staff; raising awareness of self-neglect and sharing knowledge to ensure staff understand how best to support to patients in these circumstances;

These achievements are thanks to the passion and dedication of our staff who consistently go the extra mile in their efforts to provide the best care for our patients and service users, considering people’s wider needs as well as their immediate health and social care needs.

Our impact on… our community Along with the difference we make for our patients, we continue to develop and expand the ways we deliver additional benefits for our communities; both through our own initiatives and by working in partnership with local charities and community groups to make a positive difference for local people. In 2017-18 this included: 

Organising interactive health information events in locations across the community, helping people to live well and offering advice. These events covered a number of topics including:  staying safe in the sun  how to check your moles  offering breathing tests that measure lung function for people who are concerned about their breathing or regular chest infections, and referring them on for further investigation where appropriate;

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Joining a local Pensioners Information and Advice Fair to showcase the range of support our services can provide; including dementia support and providing information on exercising safely as you get older;

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Our community rehabilitation service has been running outreach events engaging with local religious and community groups, raising awareness of the support available for people living with long term conditions and encouraging people to access health and care services. Working in partnership with our rapid response service and our Wisdom Hospice team, we have enabled people to engage with local healthcare, offering specialist expertise and helping people to continue to live independently in the community;

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Running a neurological conditions day for local people to raise awareness of neurological conditions. We offered advice, gave people a chance to discuss their concerns with a specialist healthcare professional and referred people into our services for further assessment and care;

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We supported national health awareness campaigns to improve understanding among staff, patients and the local community, helping to improve care for patients including:  Dementia Awareness Week  Dying Matters Week  Diabetes Awareness Week including free diabetes education sessions for local people and MCH staff, as well as an education forum for GPs;

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Our specialist occupational therapist is working with the Universities at Medway to provide training for students studying occupational therapy; enabling the students to benefit from her

expertise as a highly specialist hand therapist and receive high quality training to prepare them for clinical practice; 

We continue to support our stroke survivor support group and carer support group developed in partnership with our stroke patients and their carers, enabling people to benefit from peer support and on-going contact with our specialist stroke staff. The service supports members to take on volunteer roles within the group (where they choose to), empowering people to take on responsibilities to help regain their confidence and support their continued rehabilitation;

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Our speech and language therapy service Dementia Champion attends the Dementia Café in Hoo to provide advice on speech and language difficulties associated with dementia and how to manage these. Our Dementia Champions support people with dementia to continue to live independently and well in the community and raise awareness of how their services can offer specialist support;

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Our Wisdom Hospice has been working in partnership with Ellenor Hospice in Gravesend to run an outreach programme for communities who do not access palliative care services. Running different events for different communities, providing information on the role of hospices and palliative care services and working with interpreters to ensure the events are accessible; the programme showcases the support available for patients and families and gives guidance on how to access the services for the benefit of patients in need;

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Our specialist rehabilitation wards are located within Amherst Court care home and our staff have been working in partnership with the care home to run joint activities for the home’s residents and our patients; including inviting residents to join our weekly seated exercise groups to enable them to exercise safely and improve their quality of life;

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We have provided Dementia Friends training to local organisations including Medway Police, Lloyds Bank in Chatham and Medway Youth Trust to help them understand and support the needs of people with dementia, helping Medway become a ‘dementia friendly community’ and improving quality of life for people with dementia and their families;

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Our children’s therapy service supported Medway Council’s Disability Sports Open Day showcasing a range of disability and Paralympic sports and giving local people with disabilities an opportunity to try out different sports with the support of our expert staff. The day encouraged people to engage with exercise to help improve their fitness and enrich their quality of life;

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Our falls service is working with Kent Fire and Rescue Service to trial a new referral system to improve early identification of local people at risk of falls and refer them into our service for support. Adding this preventative approach to our service will help prevent people from falling and continue to live independently and safely;

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We have worked with local community support groups to provide specialist tailored information, advice and support for people with serious illnesses or long term conditions. This includes:  our respiratory team providing information and support for the British Lung Foundation’s local Breathe Easy group  our dementia crisis support service working with the Parkinson’s and Neurology drop in café in Hoo to offer advice on dementia and the support services available;

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We reached out to local suppliers to invite them to quote for contracts valued under £35,000 to actively encourage local businesses to join our supply chain;

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Our dementia crisis support service supported the Dementia Roadshow organised by Medway Dementia Action Alliance; raising awareness and providing expert advice on dementia and offering opportunities for people to have private consultations with specialist staff;

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Our tissue viability and wound care staff organised a free pressure ulcer prevention conference for carers from care agencies to enable them to find out more about preventing and treating pressure ulcers. This was attended by over 80 staff from nursing and residential homes in Medway, helping to improve quality of life for the people they care for;

Our strategic aim is to be recognised as providing real opportunities for local people to develop their skills and careers in local communities Our commitment to our communities includes supporting local people to gain employment and some of the ways we do this are: 

Our apprenticeship scheme supports local young people to gain qualifications and work experience; so far we’ve offered 96 apprenticeships, including employing 11 local young people as apprentices in 2017-18, and we’ve recruited 35 apprentices into permanent positions with us once they qualified;

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Offering multiple work experience placements across our services to enable local people to improve their skills and gain valuable experience in health and social care and business services. These placements have ranged from secondary school students to work

shadowing opportunities for qualified clinicians and GPs to observe the specialist use of ultrasound in physiotherapy; 

Our MCH Academy supports local students from families on low incomes to study for a business degree at Canterbury Christ Church University; offering each student £3,000 in sponsorship each year and a 12 month paid internship with our business teams. So far we have:  offered 2 internships for students already studying at Canterbury Christ Church University (one of whom now has a permanent position at MCH);  sponsored 2 students who have completed their degree and graduated this summer;  sponsored a third student who has completed the second year of his degree and joined us this summer to begin his 12 month paid internship;

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Worked with Bemix CIC (formerly Skillnet CIC) to offer a 6 months supported internship for William, a young person with a learning disability, to give him the opportunity to develop his skills and gain experience to help him progress into paid employment. William did a hospitality rotation at our specialist nursing home for people with dementia, Darland House, where he worked with reception staff learning front of house skills, with the housekeeping team and with the catering team, his favourite part of the placement;

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Signed up to the Step into Health programme connecting NHS organisations to the armed forces; offering an access route into employment and providing career development opportunities for people leaving the armed forces;

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Our specialist rehabilitation wards are located within Amherst Court care home and our staff have been providing opportunities for care home staff to shadow them on our wards as well as inviting the care home staff to join our training sessions, helping to improve the knowledge and skills of all staff for the benefit of residents;

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Running a work experience scheme for local students with learning disabilities in partnership with MidKent College, supporting the students to develop their confidence as well as their communication and team working skills;

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Our on call GP service, MedOCC, offers work experience placements for Combat Medical Technicians in the TA who have no professional medical qualifications, helping them gain practical experience to support them in their role;

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Our Wisdom Hospice works in partnership with MidKent College to offer placements for students studying counselling, supporting students to gain the 100 hours of work experience they need to complete the course;

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Working with local schools to support careers events and discuss career opportunities in health and social care and how to begin a career in this sector; including supporting the Explore Health and Care Careers event in Sheppey organised by Swale Clinical Commissioning Group and Health Education Kent Surrey and Sussex, by giving a talk on careers in adult nursing and dementia care.

Our impact on… our staff Our success in providing high quality care and added social value is thanks to the passion and dedication of our staff; we are making the most of our opportunities as a social enterprise to invest in our employees and make MCH an employer of choice for local people. Some of the ways we are doing this are: 

As a social enterprise, our staff can choose to become co-owners and take part in making decisions for our future; we are pleased to have welcomed 77% of staff as co-owners so far, influencing how MCH develops and grows;

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Continuing to offer opportunities for staff to develop their skills and careers, from specialist clinical and business skills to our leadership development pathway. In 2018 we are expanding our apprenticeship programme to offer increased opportunities for staff to study for recognised qualifications in healthcare, business administration and leadership and management, supporting our people to progress in their careers;

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Our elected members forum (EMF) of co-owners works in partnership with our Board and plays an active role in representing the views of our staff. Our EMF Chair is our Freedom To Speak Up (FTSU) Guardian who supports staff to raise concerns, and fellow EMF representatives also act as FTSU guardians;

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Employing 1,036 local people living in Medway and Swale, 78% of our workforce;

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We are a registered Disability Confident Employer with the Department for Work and Pensions, in recognition of our commitment to the employment and career development of people with disabilities;

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Our volunteers are an integral part of our teams, bringing energy and compassion and helping us to deliver care and make a positive impact on the health and wellbeing of our patients, our staff and the volunteers themselves; we have over 100 volunteers offering a wide range of support to the Wisdom Hospice and many more supporting our patients in our other services. This year we introduced awards for our volunteers to recognise their commitment and the value they add to our services for our patients;

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Offering free Pilates classes for our staff run by our MSK physiotherapy team, promoting a healthy lifestyle as well as relieving stress and tension;

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Refreshing our wellbeing at work programme to support our staff to care for their physical, emotional and mental wellbeing. We ran initiatives such as healthy eating education sessions, secured discounted membership fees with local gyms and provided a healthy weight programme run by our nutrition and dietetics team;

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Our Recognising Excellence annual staff awards received 108 nominations from the people we care for and members of staff in 2017-18, showcasing the difference our people make every day for our patients and acknowledging the value of the impact they have;

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We pay the Foundation Living Wage (which is above the National Living Wage) as a minimum to all our staff, helping to support quality of life by enabling people to earn a wage that supports a basic standard of living.

Promoting clinical research We are committed to offering the best care for our patients and continue to promote clinical research to support the development of new treatments and techniques that could benefit the people we care for. Just some of the studies we are currently involved in are:       

EMBARC – a study looking into a European register for patients with Bronchiectasis; Alcohol study – a study looking into patients with advanced cancer and their caregivers, and alcohol-related problems as a coping mechanism; Feeding and Autoimmunity in Downs Syndrome Evaluation (FADES) – a study evaluating feeding and autoimmunity in Downs Syndrome; Predicting Language Outcome and Recovery after Stroke (Ploras) – a study looking into predicting recovery of language deficits post-stroke; Propel – a study looking into the implementation of an evidence-based pelvic floor muscle-based training intervention for women with pelvic organ prolapse; OPEL – A study looking into Hospice at Home services for End of Life care; Grasp – A study looking at different treatment approaches to shoulder pain.

We work in collaboration with a number of research specific organisations and networks, academic institutions, industry and other care providers locally, nationally and internationally; and are a member of the Health and Europe Centre, an alliance enabling us to bid for and run Europeanfunded research projects. We are currently participating in three large scale international projects: 

DWELL (Diabetes and WELLbeing) involves eight partners from the UK, Belgium, the Netherlands and France and will enable 1,000 patients in these countries with type 2 diabetes to access tailored support, empowering them to self-manage their condition and improve their wellbeing.

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TICC (Transforming Integrated Care in the Community) will create systemic change in health and social care, providing services better suited to our ageing population by addressing holistic needs. The model consists of self-managing teams of nurses working at a neighbourhood level handling every aspect of care and business. It coaches rather than manages patients, providing better outcomes for people, lower costs, fewer unplanned hospital admissions and greater consistency of care;

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CASCADE (Community Areas of Sustainable Care and Dementia Excellence in Europe) involves ten partners and will see the construction of two new facilities for the

elderly and for people living with dementia, as well as creating a Centre of Excellence for dementia sufferers across the partner regions. It will provide training for 2,500 people, care for 2,700 people and we will be developing small scale care known as 'guesthouses' for elderly people with dementia, which will provide respite care within our local community.

Growing our social enterprise As a social enterprise we have created opportunities to expand and diversify our business; developing our health and social care services as well as investing in new business services (MCH+) to generate income. As a for better profit organisation we reinvest any surplus back into improving our health and care services and into our local communities.

MCH+ services Our MCH+ services are delivered by our expert staff and designed to meet the needs of our communities: 

Our musculoskeletal physiotherapy service has introduced seated exercise classes specially designed for people who are elderly and/or frail, enabling people to exercise safely in a supportive environment and learn exercises that can be easily repeated at home; helping to improve physical fitness and quality of life;

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Our children’s therapy service runs Pilates classes specially designed for young people aged 9 – 16 to help improve posture, core strength and coordination;

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Our social nail care service, developed in response to requests from our patients, helps people to care for their feet and toe nails and is available at clinics across Medway or as a home visit;

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Our children’s therapy service provides speech and language training for teachers and schools to help school staff better support pupils with therapy needs;

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Our social activity centre, ourZone, offers a social care showering facility and the opportunity for non-members to use the sensory / relaxation room;

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Our musculoskeletal physiotherapy service runs Pilates classes for local people, led by a qualified physiotherapist;

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The Walter Brice Centre offers a bathing service with specialist equipment and trained staff to support patients;

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Darland House, our specialist dementia care nursing home, runs a professional catering service for meetings and lunches;

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Our musculoskeletal physiotherapists are trained to use acupuncture to manage pain and offer a low cost drop-in service accessible to all;

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Our podiatry team has set up a new service to provide treatment for people with common foot care problems that donâ&#x20AC;&#x2122;t meet the criteria for the NHS service. Offering treatment for concerns including corns, calluses, in-growing toe nails, painful feet and verrucae; the service is low cost and run by our experienced staff who can offer expert advice and ensure any serious problems are picked up at an early stage.

Ambley Care As part of our strategy to develop social care, we have set up a new subsidiary company, Ambley Care, to provide domiciliary care in and around Medway. Sharing our MCH values and ethos, Ambley Care has been supporting local people since October 2016 and makes use of the wealth of expertise, knowledge and compassion we've earned at MCH, using it to provide excellent care at home and in our communities.

Improving through innovation As part of our commitment to providing high quality care we are investing in and trialling new technology to discover how it can help us to better support our patients. We are also exploring new ideas and new developments within healthcare and trialling them within our services to ensure we continue to provide the best care for our patients into the future.

Telehealth technology Our long term conditions teams continue to explore different ways technology can be used to support patients living with long term conditions. They look at how we can make it easier and more convenient for patients to monitor their health and empower people with the knowledge and tools to self-manage their condition. Our respiratory service is successfully trialling telehealth technology including video consultations and remote monitoring technology – medical equipment that enables patients to measure their own routine observations including blood pressure, oxygen levels and heart rate. We are using this technology in combination with usual appointments with a clinician to enhance the service we provide and support patients to take more control over managing their health. We’ve found that remote monitoring technology works best for patients when used together with video consultations and we’re now looking at how we can use this technology within our other long term conditions services to replicate the benefits for more of our patients. As well as empowering patients our trials have demonstrated other positive differences, including that the use of video consultations and remote monitoring is more convenient for people as it reduces the need to travel to clinics. Patients were also able to use the video consultation technology to have video phone calls with family and friends, helping to reduce social isolation for vulnerable people.

SpeakSet We have purchased the technology that runs video consultations through patients’ televisions in their own homes and are selling the service to other care providers across the country to help support their patients. In addition to generating income for MCH and our Albion partners, owning the technology gives us the freedom to fully explore its potential to deliver both health benefits and wider benefits for our patients.

Our charity – Medway Cares Medway Cares supports projects and activities that enhance the health, care and wellbeing of local people and aims to address health inequalities in the local community. Established in 2012, so far Medway Cares has awarded over £185,000 in funding to support local people. We are proud of the positive impact Medway Cares has had in the community and of the positive outcomes the charity has achieved for local people. In 2017-18 Medway Cares awarded over £30,500 to new projects nominated by our staff - just one of the ways our staff and co-owners have a say in how our surplus is reinvested for the benefit of the local community. The awards include: 

£5,500 to purchase a specially adapted trampoline and swing for the Snapdragons Child Development Centre for children with disabilities to play on and use in therapy sessions;

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£9,559 to fund apprenticeships with MCH teams to support local young people to take the first step in their career;

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£802 to develop an enteral feeding passport to give to patients with feeding tubes to inform other services providing care for these patients, and to help improve understanding of feeding tubes and prevent complications;

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£996 to fund an emergency lifting cushion that will be available during clinics for patients who have fallen or are at risk of falling, to help lower them to the floor in a controlled manner;

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£4,204 to redecorate and refurnish the staff rest room at Darland House, our specialist nursing home for people with dementia. We created an environment for staff to be able to relax and somewhere for families to rest when staying overnight to be with relatives when they are unwell;

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£295 to purchase a shed and plants for the allotment used by the local Medway Gingerbread Activity group, supporting single parent families in our communities to meet and learn together, building their support network and improving their wellbeing;

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£1,074 to fund two members of staff to attend the European Respiratory Society Congress, enabling them to present their research findings and learn from research on the most up to date ideas and techniques;

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£817 to purchase a Freezepen for our podiatry service to be able to provide treatment for foot care problems that do not meet the criteria for the NHS service;

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£920 to purchase a set of ‘roll on roll off’ wheelchair scales for use by people with restricted mobility, to help them monitor their weight more easily, while respecting their dignity;

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£157 to purchase a Kindle for use by children when having blood tests, acting as a distraction for children with higher levels of anxiety and improving their experience of care;

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£424 to purchase equipment to support a higher level of rehabilitation for physiotherapy patients, increasing opportunities for rehabilitation and supporting them to access other fitness activities independently once discharged from the service;

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£1,110 for a variety of smaller awards including the purchase of bereavement books to support children suffering a bereavement, and specialist nursery fees for a child with complex needs to provide respite for mum during difficult circumstances.

Our environment We take pride in respecting the environment and continue to seek ways to ensure that we reduce our impact on the world we live in. Some of the ways we are doing this are: 

Through our waste contract - we have been working towards 0% of our waste going to landfill and achieved this target in August 2017;

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Designing a Green Programme to enable us to reduce our carbon footprint and become a more environmentally friendly organisation. The programme means us taking an organisational approach to everything from recycling to saving electricity. We are developing initiatives to support our services, and working with our Elected Members Forum to promote the programme and encouraging staff to suggest ideas and identify areas for improvement;

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Implementing a new hybrid mail system in autumn 2018 so all letters will be emailed to a central location to be printed; reducing our multiple post collections down to one and reducing our carbon footprint. We are also increasing the use of email to communicate with patients (where they agree) to reduce the number of letters we send;

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We successfully trialled the use of an electric car within our out of hours community nursing team for staff to use when going on home visits to patients. We are now exploring how to extend its use to our other services to further reduce pollution and our carbon footprint;

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Supporting recycling across our organisation including:  Introducing improved recycling bins to increase recycling in our offices;  swapping single use plastic cups in water machines for recyclable paper cups; and  buying recycled products wherever possible and identifying opportunities to swap to recycled products; such as changing the toilet roll fittings at one of our sites so we can buy recycled paper toilet rolls at all our locations;

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Our new facilities management contract includes a commitment to planned, preventative maintenance and an agreement to include non-urgent reactive work when undertaking planned work. Together this will reduce the number of reactive calls and the number of journeys made by maintenance staff to our sites, reducing our carbon footprint;

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We buy environmentally friendly hand soap and plan to explore whether we can use environmentally friendly cleaning products; liaising with our patient safety team to ensure we comply with infection prevention and control requirements.

Looking ahead We are proud of our success in embedding social value into our business culture, and continuing to make a positive impact for our patients and our communities is fundamental to our plans for the future. Ideas being incorporated into our plans for 2018-19 include: 

Building on the improvements made at our Walter Brice Centre in Hoo to increase the services and clinics offered at the centre and develop the centre into a care hub for local people - improving provision of care and access to services for patients on the peninsula;

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Our adult learning disability team is exploring the potential to develop a patient passport for their patients to take with them when they go into hospital. This would contain important information about their health care and would improve communication between our services and the hospital and help ensure continuity of care for our patients;

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Our GP practices are assessing the current provision of medical care for homeless people living in Medway and are developing a pilot project in partnership with local charity Charing Hands. The GP practices would run weekly drop-in clinics led by our advanced care practitioner nurses to enable homeless people to access healthcare;

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Our long term conditions teams are exploring the possibility of running a long term conditions conference for local GPs. The aim is to raise awareness of the role of the services and the support they can provide to help people with long term conditions continue to live independently and well in the community;

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We look forward to welcoming our third MCH Academy sponsorship student to join us as an intern for the start of his placement year to gain practical experience working with our business teams;

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Our nutrition and dietetics service is working with our community nursing teams to embed specialist training on how to care for patients with enteral feeding tubes into our induction programme for new community nurses. This will enable patients with complex needs to receive more of their care in the community;

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Our children’s therapy service is building on the success of the social prescribing programme it has developed for children and their families which signposts families to services offering them further support as well as supporting people to engage in community activities. The service plans to develop this further in 2018-19 to support more children and

their families to engage with their local community to help improve their quality of life and emotional wellbeing; 

Further developing the gym at our social activity centre, ourZone, to include neurotherapy exercise bikes; improving facilities for members and making it easier for our members with disabilities to enjoy the benefits of exercise;

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Expanding our innovative provision for stroke patients by introducing a physiotherapy and occupational therapy group for people recovering from a stroke in the community. The group will run at our newly refurbished ourZone building, making it easier for patients to access therapy after leaving hospital and enabling people to meet others also recovering from a stroke, providing the benefit of peer support;

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Our community nursing service is working in partnership with the mental health team for older people at Kent and Medway NHS and Social Care Partnership Trust to improve communication between our services. We are inviting community psychiatric nurses to join our multidisciplinary team meetings and have agreed for our advanced care practitioner nurses to refer patients directly to the mental health team without needing a GP referral. This will help to streamline care and ensure patients with dementia and other mental health conditions can access specialist care more quickly;

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Developing nursing associate roles and associate practitioner roles for therapy staff to enable staff to work towards recognised qualifications and progress in their careers. As well as supporting our dedicated and committed staff, these roles will also benefit our patients by improving the knowledge and skills of our staff.

How to provide feedback on this report We would like to hear your comments and feedback on this report and any suggestions you may have for the future. Your feedback For further information or to request a hard copy of this report please contact the medch.communications@nhs.net or call 01634 334686. Other languages This information can be made available in other languages and formats. To become a member of our community forum visit:www.medwaycommunityhealthcare.nhs.uk/join-in Find us You can find us on:Facebook - www.facebook.com/medwayhealth Twitter - www.twitter.com/medwayhealth LinkedIn - www.linkedin.com/company/medway-community-healthcare YouTube - www.youtube.com/medwayhealth Or visit our website at www.medwaycommunityhealthcare.nhs.uk